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Relationship between glomerular dysfunction and left-ventricular mass independent of haemodynamic factors in a

Fabian Maunganidze1, Gavin R Norton, Muzi J Maseko

  • 1Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.

Journal of Hypertension
|April 26, 2013
PubMed

Insights

Early kidney dysfunction is linked to increased left-ventricular mass (LVM) in the general population, independent of blood pressure and other hemodynamic factors. This suggests non-hemodynamic mechanisms contribute to cardiac changes in early glomerular disease.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Early glomerular dysfunction, indicated by reduced estimated glomerular filtration rate (eGFR), may impact cardiovascular health.
  • Left-ventricular mass (LVM) is a marker of cardiac remodeling and a predictor of cardiovascular events.
  • The relationship between early kidney dysfunction and LVM, and its dependence on hemodynamic factors, requires investigation in community samples.

Purpose of the Study:

  • To determine if a relationship exists between early glomerular dysfunction (eGFR) and left-ventricular mass (LVM) in a community sample.
  • To investigate whether this relationship is influenced by hemodynamic factors such as blood pressure and vascular stiffness.

Main Methods:

  • A community-based sample of 621 participants, including 332 normotensive individuals, was studied.
  • Estimated glomerular filtration rate (eGFR) and left-ventricular mass (LVM) were assessed.
  • Hemodynamic parameters including aortic blood pressure (BP), pulse wave velocity (PWV), and 24-h BP were measured.

Main Results:

  • Reduced eGFR was significantly associated with increased LVM index (LVMI) and inappropriate LVM (LVMinappr) in the overall sample and in normotensive individuals.
  • These associations remained robust even after adjusting for confounders and replacing clinic BP with aortic BP, 24-h BP, or PWV in regression models.
  • The relationship between eGFR and LVM was particularly pronounced at eGFR levels below 132 ml/min per 1.73 m².

Conclusions:

  • Strong associations between eGFR and LVM exist at a community level, irrespective of hypertension status.
  • These relationships are independent of various hemodynamic factors, including 24-h and aortic BP, PWV, stroke work, and wall stress.
  • Non-hemodynamic factors play a significant role in the link between early glomerular dysfunction and left-ventricular hypertrophy.
Abstract

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